Exotropic drift and ocular alignment after surgical correction for intermittent exotropia

J Pediatr Ophthalmol Strabismus. 2010 Jan-Feb;47(1):12-6. doi: 10.3928/01913913-20100106-04. Epub 2010 Jan 21.

Abstract

Purpose: To evaluate changes in the angle of deviation over time and compare the motor success rate with different initial postoperative deviation in patients undergoing surgical correction for intermittent exotropia.

Methods: Forty-eight patients aged between 1 and 10 years who underwent bilateral lateral rectus recession for intermittent exotropia were retrospectively evaluated. Preoperative and postoperative ocular deviations at 1 week, 1 month, and 6 months were analyzed. Full surgical correction was attempted in all patients. Motor success was defined as ocular deviation within 10 prism diopters of orthophoria at 6 months postoperatively.

Results: The follow-up period ranged from 6 months to 3 years. Although most patients had exotropic drift, this drift was greater in patients with initial esotropia (86.7%) and orthophoria (70.0%) compared to patients with exotropia (26.1%). Motor success was achieved in 29 (60.4%) patients. There was no statistical difference between ocular alignment at 1 week postoperatively and final motor success (P = .782). There was good correlation between ocular alignment at 1 week and 6 months postoperatively (rho = 0.585, P < .001). Age and preoperative deviation were not found to be associated with motor success.

Conclusions: The success rate appears to be unaffected by initial ocular alignment, suggesting that deliberate initial overcorrection may be unnecessary. Future studies are warranted to evaluate the long-term stability of this alignment.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Child, Preschool
  • Depth Perception
  • Exotropia / physiopathology*
  • Exotropia / surgery
  • Eye Movements*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Oculomotor Muscles / physiopathology*
  • Oculomotor Muscles / surgery
  • Ophthalmologic Surgical Procedures / methods*
  • Reoperation
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome